U.S. patent application number 15/190636 was filed with the patent office on 2016-12-29 for method and system for surgical instrumentation setup and user preferences.
The applicant listed for this patent is Brian D. BAILEY, Richard A. BEUTTER, Hassan H. FARID, Benjamin H. FEINGOLD, Sean HASTINGS, Ramanan PARAMASIVAN, Andrew SCHULTZ, John Thomas SHEN, Lauren A. STAMPER. Invention is credited to Brian D. BAILEY, Richard A. BEUTTER, Hassan H. FARID, Benjamin H. FEINGOLD, Sean HASTINGS, Ramanan PARAMASIVAN, Andrew SCHULTZ, John Thomas SHEN, Lauren A. STAMPER.
Application Number | 20160379504 15/190636 |
Document ID | / |
Family ID | 57601180 |
Filed Date | 2016-12-29 |
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United States Patent
Application |
20160379504 |
Kind Code |
A1 |
BAILEY; Brian D. ; et
al. |
December 29, 2016 |
METHOD AND SYSTEM FOR SURGICAL INSTRUMENTATION SETUP AND USER
PREFERENCES
Abstract
A method of setting up an operating room including placing at
least one surgical device on at least one surface in the operating
room, capturing an image of the at least one surgical device with a
camera, comparing actual attributes of the at least one surgical
device determined using the image captured by the camera with
desired attributes of the at least one surgical device stored in a
digital preference storage using a computer system, and issuing
instruction information of the at least one surgical device in the
operating room, the instruction information being dependent on
results of the step of comparing.
Inventors: |
BAILEY; Brian D.; (San Jose,
CA) ; SHEN; John Thomas; (San Jose, CA) ;
FARID; Hassan H.; (Houston, TX) ; STAMPER; Lauren
A.; (Allen, TX) ; FEINGOLD; Benjamin H.;
(Tucson, AZ) ; PARAMASIVAN; Ramanan; (San Jose,
CA) ; HASTINGS; Sean; (Frisco, TX) ; BEUTTER;
Richard A.; (Argyle, TX) ; SCHULTZ; Andrew;
(San Diego, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
BAILEY; Brian D.
SHEN; John Thomas
FARID; Hassan H.
STAMPER; Lauren A.
FEINGOLD; Benjamin H.
PARAMASIVAN; Ramanan
HASTINGS; Sean
BEUTTER; Richard A.
SCHULTZ; Andrew |
San Jose
San Jose
Houston
Allen
Tucson
San Jose
Frisco
Argyle
San Diego |
CA
CA
TX
TX
AZ
CA
TX
TX
CA |
US
US
US
US
US
US
US
US
US |
|
|
Family ID: |
57601180 |
Appl. No.: |
15/190636 |
Filed: |
June 23, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62183995 |
Jun 24, 2015 |
|
|
|
Current U.S.
Class: |
434/219 |
Current CPC
Class: |
A61B 34/10 20160201;
G09B 5/02 20130101; G06F 16/583 20190101; G06K 9/3241 20130101;
G06K 9/00208 20130101; G06F 16/50 20190101; G06T 7/001 20130101;
G16H 40/63 20180101; G06K 9/00201 20130101; A61B 2562/08
20130101 |
International
Class: |
G09B 5/02 20060101
G09B005/02; G09B 21/00 20060101 G09B021/00 |
Claims
1. A method of setting up an operating room comprising: placing at
least one surgical device on at least one surface in the operating
room; capturing an image of the at least one surgical device with a
camera; comparing actual attributes of the at least one surgical
device determined using the image captured by the camera with
desired attributes of the at least one surgical device stored in a
digital preference storage using a computer system; and issuing
instruction information of the at least one surgical device in the
operating room, the instruction information being dependent on
results of the step of comparing.
2. The method of claim 1, wherein: the at least one surface is on a
portable table.
3. The method of claim 1, wherein: issuing instruction information
comprises displaying the instruction information on a display of
the computer system.
4. The method of claim 1, wherein: the camera is fixed in position
relative to the at least one surface.
5. The method of claim 4, wherein: the at least one surface is on a
portable cart and the camera is fixedly connected to the portable
cart.
6. The method of claim 5, further including: communicating the
image from the camera to the computer system.
7. The method of claim 5, wherein: the image is wirelessly
communicated from the camera to the computer system.
8. The method of claim 5, wherein: the image is communicated from
the camera to the computer system over a wired system.
9. The method of claim 1, wherein: the at least one surgical device
includes surgical instruments; and the actual attributes of the at
least one surgical device include a number of each of the surgical
instruments.
10. The method of claim 1, wherein: the at least one surgical
device includes surgical instruments; and the actual attributes of
the at least one surgical device include a style of each of the
surgical instruments.
11. The method of claim 1, wherein: the at least one surgical
device includes surgical instruments; and the actual attributes of
the at least one surgical device include a brand of each of the
surgical instruments.
12. The method of claim 1, wherein: the at least one surgical
device includes surgical instruments; and the actual attributes of
the at least one surgical device include a location of each of the
surgical instruments.
13. The method of claim 1, wherein: the at least one surgical
device includes surgical instruments; and the actual attributes of
the at least one surgical device include a presence of each of the
surgical instruments.
14. The method of claim 1, further including: relocating the at
least one surgical device on the at least one surface according to
the instruction information.
15. The method of claim 1, further including: adding at least one
further surgical device to the at least one surface according to
the instruction information.
16. The method of claim 1, further including: removing at least one
surgical device from the at least one surface according to the
instruction information.
17. The method of claim 16, further including: adding at least one
further surgical device to the at least one surface according to
the instruction information.
18. The method of claim 1, wherein: the at least one surface is
located in a room; and the camera is fixed in location within the
room.
19. The method of claim 1, wherein: the computer system is an image
and capture and display system.
20. The method of claim 1, further including: connecting the
computer system to a hospital information technology system.
21. The method of claim 1, wherein: the at least one surface is a
floor of a room.
22. The method of claim 20, wherein: the at least one surgical
device comprises surgical equipment on the floor of the room.
23. The method of claim 21, further including: placing further
surgical equipment in the room according to the instruction
information.
24. The method of claim 21, further including: moving a location of
the surgical equipment according to the instruction
information.
25. The method of claim 25, wherein: the at least one surface
comprises a plurality of shelves on a portable cart.
26. The method of claim 24, wherein: the at least one surgical
device is a plurality of surgical devices, at least one of the
surgical devices being on one of the shelves of the cart.
27. The method of claim 25, wherein: the instruction information
includes an indication that all of the surgical devices are
properly located.
28. The method of claim 25, wherein: the instruction information
includes instructions for moving at least one of the at least one
surgical device.
29. The method of claim 25, wherein: the instruction information
includes instructions for removing at least one surgical
device.
30. The method of claim 25, wherein: the instruction information
includes instructions for adding at least one further surgical
device.
31. A method of arranging a medical care area, comprising: locating
at least one medical or surgical device in the medical care area;
capturing an image of the at least one medical or surgical device
with a camera, the image including at least one actual attribute of
the at least one medical or surgical device; storing at least one
desired attribute of the at least one medical or surgical device in
a digital preference storage using a computer system; comparing the
at least one actual attribute of the at least one medical or
surgical device using the image captured by the camera with the at
least one desired attribute stored in the digital preference
storage; and issuing instruction information in the medical care
area to personnel responsible for arranging the medical care area,
the instruction information including at least one of: the number
present, the style, the location and the orientation of the at
least one medical or surgical device located in the medical care
area.
32. A method of setting up an operating room comprising: locating
at least one surgical device on at least one surface in the
operating room; capturing at least one image of the at least one
surgical device with at least one camera; comparing actual
attributes of the at least one surgical device determined using the
at least one image captured by the at least one camera with desired
attributes of the at least one surgical device stored in a storage
using a computer system; and issuing instruction information of the
at least one surgical device in the operating room, the instruction
information being dependent on results of the step of
comparing.
33. The method of claim 32, wherein: the at least one surgical
device comprises a plurality of surgical instruments; the actual
attributes is a final number of surgical instruments after a
surgical procedure; the desired attributes is a preliminary number
of surgical instruments before a surgical procedure; the
instruction information is a notification that the final number of
surgical instruments is not identical to the preliminary number of
surgical instruments.
34. The method of claim 32, wherein: the at least one surgical
device includes a surgical table; and the actual attributes and the
desired attributes include data relative to a distance of the
surgical table from the at least one surface.
35. The method of claim 32, wherein: the at least one surgical
device includes a surgical light; and the actual attribute of the
surgical light is a location of the surgical light.
36. A method of recording operating room procedures comprising:
capturing at least one image of personnel in an operating room
during a medical procedure on a patient, the personnel not
including the patient; using recognition software to determine a
status of the personnel; and recording the status of the personnel
in a storage using a computer system.
37. The method of claim 36, wherein: the status includes an
identity of the personnel in the operating room during the medical
procedure; and the identity of the personnel in the operating room
during the medical procedure is recorded in an electronic medical
record of the patient.
38. The method of claim 36, wherein: the status of the personnel
includes a number of times the personnel enters and exits the
operating room.
39. The method of claim 36, wherein: the status of the personnel
includes a presence of essential personnel; and further including
the step of notifying the personnel in the operating room if
essential personnel is missing from the operating room.
40. The method of claim 36, wherein: the status of the personnel
includes a number of times the personnel violates a sterile
field.
41. The method of claim 36, wherein: the status of the personnel
includes active and idle time of the personnel.
42. The method of claim 36, wherein: the status of the personnel
includes hand placement of the personnel during the medical
procedure.
43. A method of sterilizing an operating room comprising: capturing
at least one image of the operating room; determining if people are
in the operating room from analysis of the at least one image; and
triggering ultraviolet room sterilization of the operating room if
the step of determining determines that no people are in the
operating room.
44. A method of alerting personnel in an operating room of a
potential hazard comprising: capturing at least one image of the
operating room with a hyperspectral image; determining if a
potential hazard is in the operating room from analysis of the at
least one image captured by the hyperspectral image; and notifying
the personnel in the operating room when there is a determination
that there is the potential hazard.
45. A method of alerting personnel in an operating room of a
potential risk comprising: capturing at least one sound in the
operating room with a microphone; analyzing the at least one sound
captured by the microphone; alerting the personnel in the operating
room of the potential risk if the step of analyzing determines that
there is a potential risk in the operating room.
Description
CROSS REFERENCE TO RELATED APPLICATION
[0001] This claims the benefit of U.S. Provisional Application Ser.
No. 62/183,995, filed Jun. 24, 2015.
FIELD OF THE INVENTION
[0002] The present invention relates to a method of setting up a
medical care area, such as an operating room, and in particular to
a method of arranging medical or surgical devices in an operating
room.
BACKGROUND OF THE INVENTION
[0003] Current methods for set up of medical care areas, such as an
operative theater, include arranging the medical care area or
operative theater according to the instructions on a surgical
preference card. For each procedure that a surgeon performs, a
separate preference card is maintained. The surgical preference
cards outline a variety of items, including surgical equipment
preference and layout, patient positioning, and surgical video
equipment setup. At a large hospital, where there are many surgeons
and many procedures to be performed, thousands of surgical
preference cards must be arranged, tracked and utilized.
[0004] Surgical preference cards have become extremely important as
hospitals push toward more efficient workflows and strive to
complete more surgeries in any given day. The surgical preference
cards help the surgical staff avoid time consuming (and costly)
situations wherein the equipment is improperly arranged in the
operative theater prior to surgery and/or essential equipment is
missing. Many products have recently been employed to automate
management, creation and use of the surgical preference cards
including digitizing the surgical preference cards.
[0005] A fast, easy and reliable method of arranging the medical or
surgical devices in a medical care area is desired.
SUMMARY OF THE INVENTION
[0006] The present invention, according to one aspect, is directed
to a method of setting up an operating room including placing at
least one surgical device on at least one surface in the operating
room, capturing an image of the at least one surgical device with a
camera, comparing actual attributes of the at least one surgical
device determined using the image captured by the camera with
desired attributes of the at least one surgical device stored in a
digital preference storage using a computer system, and issuing
instruction information of the at least one surgical device in the
operating room, the instruction information being dependent on
results of the step of comparing.
[0007] Yet another aspect of the present invention is to provide a
method of arranging a medical care area. The method includes
placing at least one medical or surgical device in the medical care
area, capturing an image of the at least one medical or surgical
device with a camera, with the image including at least one actual
attribute of the at least one medical or surgical device, storing
at least one desired attribute of the at least one medical or
surgical device in a digital preference storage using a computer
system, comparing the at least one actual attribute of the at least
one medical or surgical device using the image captured by the
camera with the at least one desired attribute stored in the
digital preference storage, and issuing instruction information in
the medical care area to personnel responsible for arranging the
medical care area, the instruction information including at least
one of: the number present, the style, the location and the
orientation of the at least one medical or surgical device located
in the medical care area.
BRIEF DESCRIPTION OF THE DRAWINGS
[0008] One or more embodiments of the present invention are
illustrated by way of example and should not be construed as being
limited to the specific embodiments depicted in the accompanying
drawings, in which like reference numerals indicate similar
elements.
[0009] FIG. 1 is a perspective view of an operating room
illustrating examples of surgical devices used in a method of the
present invention.
[0010] FIG. 2 illustrates a top view of an example of surgical
instruments on a surface used in the method of the present
invention.
[0011] FIG. 3 illustrates a method of properly locating the
surgical instruments.
[0012] FIGS. 4A-4E illustrate top views of the surgical instruments
on the surface of FIG. 2 after actual attributes of the surgical
instruments have been changed to match desired attributes of the
surgical instruments.
[0013] FIG. 5 illustrates a method of properly locating the
surgical equipment in an operating room.
[0014] FIGS. 6A-6E illustrate schematic top views of the operating
room of FIG. 1 before (FIG. 6A) and after (FIGS. 6B-6E) actual
attributes of the surgical equipment have been changed to match
desired attributes of the surgical equipment.
[0015] FIG. 7 illustrates a schematic view of a floor of a medical
facility.
[0016] FIG. 8 illustrates a method of improving efficiency in the
medical care facility according to an aspect of the present
invention.
[0017] The specific devices and processes illustrated in the
attached drawings, and described in the following specification are
simply exemplary embodiments of the inventive concepts. Hence,
specific dimensions and other physical characteristics relating to
the embodiments disclosed herein are not to be considered as
limiting.
DETAILED DESCRIPTION
[0018] For purposes of description herein, it is to be understood
that the invention may assume various alternative orientations,
except where expressly specified to the contrary. It is also to be
understood that the specific devices and processes illustrated in
the attached drawings, and described in the following specification
are simply exemplary embodiments of the inventive concepts defined
in the appended claims. Hence, specific dimensions and other
physical characteristics relating to the embodiments disclosed
herein are not to be considered as limiting, unless the claims
expressly state otherwise.
[0019] FIG. 1 depicts a perspective view of a medical care area 10,
which in the illustrated embodiment is depicted as an operating
room, according to one embodiment of the invention. In the
illustrated example, the operating room 10 includes surgical
devices placed throughout the operating room 10. The surgical
devices can include surgical instruments 12 positioned on a table
14 (stationary or portable) and surgical equipment 16 positioned on
a floor 18, on a portable cart 19a, 19b, 19c, 19d, 19e and/or on
shelving 20 in the operating room 10. An aspect of the present
invention is to ensure that the surgical devices are properly
placed and present in the operating room 10 by capturing images of
the surgical devices using optical recognition programs to
recognize the presence of the surgical devices and indicating that
all surgical devices are properly placed and present or that
changes need to be made to the surgical devices (e.g., changing the
location of one or more of the surgical devices, adding more
surgical devices and/or removing some of the surgical devices).
[0020] FIG. 2 illustrates a plurality of surgical instruments 12 on
the table 14 (or on a tray on the table 14). The surgical
instruments 12 can be any specially designed tool or device for
performing specific actions of carrying out desired effects during
a surgery or operation, such as modifying biological tissue, or to
provide access for viewing biological tissue. Examples of surgical
instruments 12 include graspers, such as forceps, clamps and
occluders for blood vessels and other organs, retractors used to
spread open skin, ribs and other tissue, distractors, positioners
and stereotactic devices, mechanical cutters (scalpels, lancets,
drill bits, rasps, trocars, Ligasure, Harmonic scalpel, rongeurs
etc.), dilators and specula for access to narrow passages or
incisions, suction tips and tubes for removal of bodily fluids,
sealing devices, such as surgical staplers, irrigation and
injection needles, tips and tubes for introducing fluid, powered
devices, such as drills, scopes and probes, including fiber optic
endoscopes and tactile probes, carriers and appliers for optical,
electronic and mechanical devices, ultrasound tissue disruptors,
cryotomes and cutting laser guides, sponges, and measurement
devices, such as rulers and calipers. The above list is not
exhaustive and is for illustrative purposes only. In the
illustrated example of FIG. 2, the surgical instruments 12 on the
table 14 include a bowl 22 holding sponges 24, a plurality of
scalpels 26, a plurality of forceps 28, a plurality of scissors 30,
a plurality of retractors 32, and a sponge clamp 34.
[0021] An aspect of the present invention is to ensure that the
proper surgical instruments 12 are located on the table 14 and in
the proper position on the table 14 according to preferences of
particular medical personnel (e.g., a surgeon) or according to a
particular procedure being performed. FIG. 3 illustrates a method
40 of properly locating the surgical instruments 12, In a first
step of the method 40, at least one surgical instrument 12 is
placed on the table 14 at step 42. Typically, a plurality of the
surgical instruments 12 are placed on the table 14 (see, for
example, FIG. 2). After the surgical instruments 12 are placed on
the table 14, a camera 36 captures an image of the surgical
instruments 12 on the table 14 at step 44. The camera 36 can be a
table camera 36a fixed to the table 14 by a bracket 46 and pointed
at the table 14 to be able to capture an image of the entire table
14 and all surgical instruments 12 thereon. The camera 36 could
also or alternatively be a room camera 36b fixed to walls 52 or a
ceiling 54 of the room 10 (e.g., a room camera 36b as shown or a
camera 36c in an overhead light 56). It is contemplated that the
camera 36 could be a high definition camera, a 360.degree. camera
and/or a wide-angle camera. The image of the surgical instruments
12 captured by the camera 36 at step 44 is then transmitted to a
computer system 48 for analysis at step 45. The computer system 48
(e.g., desktop or laptop computer) can be located in the room 10
(or elsewhere) or can be an image and video capture and recording
device 50 as discussed in more detail below. The computer system 48
includes one or more processors or other similar control devices as
well as one or more memory devices. The processor controls the
overall operation of the computer system 48 and can include
hardwired circuitry, programmable circuitry that executes software,
or a combination thereof. The processor may, for example, execute
software stored in the memory device. The processor may include,
for example, one or more general- or special-purpose programmable
microprocessors and/or microcontrollers, application specific
integrated circuits (ASICs), programmable logic devices (PLDs),
programmable gate arrays (PGAs), or the like. The memory device may
include any combination of one or more random access memories
(RAMs), read-only memories (ROMs) (which may be programmable),
flash memory, and/or other similar storage devices. It is
contemplated that the camera 36 could be a camera of a tablet
computer and the computer system 48 can be incorporated into the
tablet computer. The camera 36 can transmit the image to the
computer system 48 wirelessly or via a wired system.
[0022] After the computer system 48 receives the image of the
surgical instruments 12 captured by the camera 36 at step 45, the
computer system 48 obtains actual attributes of the surgical
instruments 12 at step 47. The actual attributes of the surgical
instruments 12 can include the number of each of the particular
surgical instruments 12, the style of the surgical instruments 12,
the brand of the surgical instruments 12, the location/orientation
of the surgical instruments 12 on the table 14 and/or the presence
of the surgical instruments 12. It is contemplated that other
actual attributes of the surgical instruments 12 could be found.
The actual attributes of the surgical instruments 12 can be found
using an image recognition algorithm (e.g., using Haar Cascade
classifier). Such image recognition algorithms are well known to
those skilled in the art. It is also contemplated that the surgical
instruments 12 could include a linear or matrix bar code thereon
for determining the actual attributes of the surgical instruments
12, It is further contemplated that the surgical instruments 12
could include indicators thereon for assisting in determining the
actual attributes of the surgical instruments 12. For example, two
surgical instruments 12 may have the same outside configuration,
but have different internal parts on components. In such a
situation, the different surgical instruments 12 could each include
a different exterior visual indicator (e.g., a modulated infrared
or other spectrum beacon, different colors, or different linear or
matrix bar code thereon) to allow the computer system 48 to
properly identify the surgical instrument 12.
[0023] For the example of the surgical instruments 12 on the table
14 illustrated in FIG. 2, the actual attributes of the surgical
instruments 12 could include the number of sponges 24 (4), scalpels
26 (2), forceps 28 (3), scissors 30 (4), retractors 32 (6) and
sponge clamps 34 (1). The actual attributes of the surgical
instruments 12 could further include the style of the surgical
instruments 12. For example, the computer system 48 can determine
the style of the retractors 32 (1 Cushing decompression retractor,
2 Senn retractors, 2 army navy retractors and 1 Weitlander
retractor in the example of FIG. 2) and/or the brand (i.e.,
manufacturer) of the retractors 32. The actual attributes of the
surgical instruments 12 could also include the location of the
surgical instruments 12. For example, the computer system 48 can
determine the location (including orientation) of the surgical
instruments 12 on the table 14 (e.g., relative to a left side edge
60, a right side edge 62, a top edge 64 and bottom edge 66 of the
table 14 as illustrated in FIG. 2). Moreover, actual attributes of
the surgical instruments 12 could further be a determination of the
presence of the surgical instruments 12. For example, the computer
system 48 can determine that the table 14 includes sponges 24,
scalpels 26, forceps 28, scissors 30, retractors 32 and sponge
clamps 34. The actual attributes can be a combination of any of the
above-noted actual attributes.
[0024] After the computer system 48 obtains actual attributes of
the surgical instruments 12 at step 47, the computer system 48
compares the actual attributes of the surgical instruments 12 with
desired attributes of the surgical instruments 12 at step 70. The
desired attributes of the surgical instruments 12 are stored in a
digital preference storage. The digital preference storage can be
saved in the computer system 48 or retrievable by the computer
system 48. It is contemplated that the computer system 48 may
process information and include the digital preference storage on
the Internet or other type of wide area network (WAN), a local area
network (LAN), a corporate intranet, any other type of network, a
combination of such networks, or can be stored in cloud storage
retrievable through a network interface of the computer system 48.
For example, the digital preference storage can be located in
existing hospital IT systems (e.g., a hospital's electronic medical
record (EMR)).
[0025] In the method 40 of properly locating the surgical
instruments 12, if the actual attributes of the surgical
instruments 12 are identical to the desired attributes as
determined at decision step 72, no further action is taken or the
computer system 48 issues instruction information indicating that
no further action is needed at step 74. The computer system 48 can
issue an indication that no further action is needed using any
visual and/or audio notification. For example, the computer system
48 can issue an "OK" message on an associated or attached display
or monitor 49, can flash a green light, can issue audio stating
that all of the surgical instruments 12 are proper and in the
correct location or any combination of the above.
[0026] However, if the actual attributes of the surgical
instruments 12 are not identical to the desired attributes as
determined at decision step 72, the computer system 48 issues
instruction information at step 76. The instruction information
will provide instructions for correcting the actual attributes of
the surgical instruments 12 to be identical to the desired
attributes. The instruction information can include displaying the
instruction information on a display or monitor 49 of the computer
system 48 and/or providing audible directions over a speaker (not
shown). The instruction information can include instructions for
removing at least one of the surgical instruments 12, adding at
least one surgical instrument 12 to the table 14 and/or moving
locations of at least one of the surgical instruments 12. For
example, the instruction information can include instructions to
add another scalpel 26a and another scissors 30a as illustrated in
FIG. 4A, substitute a Volkman retractor 32a for the Cushing
decompression retractor 32 as illustrated in FIG. 4B, swap
positions of the Weitlander retractor 32 and the sponge clamp 34 as
illustrated in FIG. 4C, rotate the Weitlander retractor 32 by
90.degree. as illustrated in FIG. 4D or remove one of the scissors
30 as illustrated in FIG. 4E.
[0027] In the illustrated example, after receiving the instruction
information at step 76, the hospital personnel can then conform the
actual attributes of the surgical instruments 12 to be identical to
the desired attributes at step 78. It is contemplated that the
method 40 of properly locating the surgical instruments 12 can
return to step 44 after step 78 to ensure that the surgical
instruments 12 are properly located.
[0028] A further aspect of the present invention is to provide the
proper surgical equipment 16 in the proper location within the
operating room 10. FIG. 1 illustrates surgical equipment 16 on the
floor 18 or shelving 20 of the operating room 10. As illustrated in
FIG. 1, examples of surgical equipment 16 include the image and
video capture and recording device 50, a video camera 120 and an
associated endoscope 138, the touchscreen monitor 49, a camera
control unit 124, a scope light source unit 126, a printer 130, a
fluid management pump 132, an insufflator 141, a shaver 136, an RF
and shaver control 134 and an additional monitor 135. However, any
piece of surgical equipment 16 that can be located within the
operating room 10 can be used. The surgical equipment 16 can
therefore include the overhead light 56 or another other item
connected to a wall or a ceiling of the room (e.g., anything on a
boom (for example, a monitor or boom shelving). Moreover, the
surgical equipment 16 can be all of the surgical equipment 16 on a
single portable cart 19a, 19b, 19c, 19d or the entire portable cart
19e itself. For example, the surgical equipment 16 can include an
image capture cart 19a having the image and video capture and
recording device 50, the video camera 120 and associated endoscope
138, the touchscreen monitor 49, the camera control unit 124, the
scope light source unit 126 and the printer 130 thereon. Further
examples of surgical equipment 16 include a pump cart 19b having
the fluid management pump 132 thereon, a RF and shaver control cart
19c having the RF and shaver control 134 thereon, an insufflator
cart 19d having the insufflator 141 thereon, a waste container cart
19e, an instrument cart 19f having the table 14 with the surgical
instruments 12 thereon, and a patient surgical table 200. Further
carts having any piece or pieces of surgical equipment 16 thereon
can also be the surgical equipment.
[0029] One example of the surgical equipment 16 is the image and
video capture and recording device 50 located in a control housing
121. The image and video capture and recording device 50 can output
images and video on the touchscreen monitor 49, which can be
integrated into the control housing 121. The image and video
capture and recording device 50 can also output images and video to
the additional monitor 135 via either a wired connection or
wirelessly. The illustrated image and video capture and recording
device 50 is therefore capable of displaying images and videos on
the touchscreen monitor 49 and/or on the additional monitor 135
captured live by cameras and/or replayed from recorded images and
videos.
[0030] The illustrated image and video capture and recording device
50 is also capable of recording images and videos. The image and
video capture and recording device 50 can include an internal hard
drive for storing captured images and videos and can also
communicate with a picture archiving and communication system
(PACS), as is well known to those skilled in the art, to save
images and video in the PACS and for retrieving images and videos
from the PACS, The image and video capture and recording device 50
can also display any saved images (e.g., from the internal hard
drive or from the PACS) on the touchscreen monitor 49 and/or the
additional monitor 135. It is contemplated that the image and video
capture and recording device 50 could obtain or create images of a
patient during a surgical procedure from a variety of sources
(e.g., from video cameras, video cassette recorders, X-ray scanners
(which convert X-ray films to digital files), digital X-ray
acquisition apparatus, fluoroscopes, CT scanners, MRI scanners,
ultrasound scanners, CCD devices, and other types of scanners
(handheld or otherwise)).
[0031] Yet another example of the surgical equipment 16 is the
camera control unit 124 that is coupled to the video camera 120 by
a flexible electronic transmission line 140. The transmission line
140 conveys video data from the video camera 120 to the camera
control unit 124 and also conveys various control signals
bi-directionally between the video camera 120 and the camera
control unit 124. The camera control unit 124 can be connected
(wired or wirelessly) to the image and video capture and recording
device 50 to provide the images and videos to the image and video
capture and recording device 50. Video cameras 120 and camera
control units 124 used with scopes 138 are well known to those
skilled in the art. An example of the video camera 120 and camera
control unit 124 for use with an endoscope is the 1488 HD Camera as
sold by Stryker Corporation of Kalamazoo, Mich.
[0032] Another example of the surgical equipment 16 is the light
source unit 126 that transmits high intensity light into the
patient through the scope 138 via a fiber optic cable 144. Light
source units 126 used with scopes 138 are well known to those
skilled in the art. An example of the light source unit 126 for use
with the endoscope 138 is the L9000 LED Light Source as sold by
Stryker Corporation of Kalamazoo, Mich.
[0033] Yet another example of the surgical equipment 16 is the
printer 130. The printer 130 can be connected to the image and
video capture and recording device 50 for outputting images from
the image and video capture and recording device 50. An example of
the printer 130 is the SDP1000 Medical Grade Digital Printer as
sold by Stryker Corporation of Kalamazoo, Mich.
[0034] Another example of the surgical equipment 16 is the fluid
management pump 132. The fluid management pump 132 is employed
during surgical procedures to introduce sterile solution into
surgical sites and to remove fluid and debris generated by the
procedure. In the illustrated example, the fluid management pump
132 can supply the motive force for pumping the sterile solution
through an inflow tube (not shown) into the surgical site via a
cannula. The fluid management pump 132 can also supply the motive
force for suctioning solution and any waste material removed from
the surgical site from an outflow tube 147 to a waste tube 137
connected to the waste container cart 19e. In the illustrated
example, the outflow tube 147 is connected to the shaver 136. An
example of the fluid management pump is disclosed in U.S. Patent
Application Publication No. 2013/0267779 entitled CONTROL FOR
SURGICAL FLUID MANAGEMENT PUMP SYSTEM, the entire contents of which
are hereby incorporated herein by reference. An example of the
shaver 136 is the FORMULA.RTM. Shaver Hand Piece as sold by Stryker
Corporation of Kalamazoo, Mich.
[0035] Yet another example of the surgical equipment 16 is the RE
and shaver control 134. The RF and shaver control 134 sends power
to an ablation and coagulation device or electrosurgical tool (not
shown) and/or the shaver 136. Ablation and coagulation devices are
well known to those skilled in the art. An example of an ablation
and coagulation device that can be connected to the RF and shaver
control 134 is the SERFAS.TM. Energy Probe as sold by Stryker
Corporation of Kalamazoo, Mich. The RE and shaver control 134 sends
power to the shaver 136 through a cable 143. An example of the RE
and shaver control 134 is the CROSSFIRE.RTM. arthroscopic resection
system as sold by Stryker Corporation of Kalamazoo, Mich.
[0036] Another example of the surgical equipment 16 is the
insufflator 141, The insufflator 141 is used to supply inert,
nontoxic gases, such as carbon dioxide, into a body cavity, in
order to expand the cavity, or to minimize visual obstruction
during minimally invasive or laparoscopic surgery. An insufflator
141 is well known to those skilled in the art. An example of the
insufflator 141 is the PNEUMOSURE.RTM. 4511 Insufflator as sold by
Stryker Corporation of Kalamazoo, Mich. Further examples or
surgical equipment 16 include stand alone pieces of surgical
equipment 16 such as a portable monitor 135a and a portable
overhead light 56a.
[0037] An aspect of the present invention is to ensure that the
proper surgical equipment 16 is located in the operating room 10
and in the proper location in the operating room 10 according to
preferences of particular medical personnel (e.g., a surgeon) or
according to a particular procedure being performed. FIG. 5
illustrates a method 100 of properly locating the surgical
equipment 16. In a first step of the method 100, at least one piece
of surgical equipment 16 is placed or positioned in the operating
room 10 at step 102. Typically, a plurality of pieces of surgical
equipment 16 (stand alone, on carts or on shelving) are placed in
the operating room 10 (see, for example, FIG. 1) and positioned in
a location in the room (e.g., a location of the surgical light 56
or any other fixed, but movable item in the room relative to the
patient surgical table 200). After the surgical equipment 16 is
placed and positioned in the operating room 10, a camera (e.g., the
wall camera 36b as shown, a camera in the overhead light 56 or the
camera of a tablet computer) captures an image of the surgical
equipment 16 at step 104. The captured image of the surgical
equipment 16 is then transmitted to the computer system 48 for
analysis at step 106. The computer system 48 (e.g., desktop or
laptop computer) can be located in the operating room 10 (or
elsewhere) or can be the image and video capture and recording
system 50. The camera 36 can transmit the image to the computer
system 48 wirelessly or via a wired system.
[0038] After the computer system 48 receives the image of the
surgical equipment 16 captured by the camera 36 at step 104, the
computer system 48 obtains actual attributes of the surgical
equipment 16 at step 108. The actual attributes of the surgical
equipment 16 can include the number of each piece of surgical
equipment 16, the style of the surgical equipment 16, the brand of
the surgical equipment 16, the location/orientation of the surgical
equipment 16 on the floor 18 or on a cart 19a, etc. and/or the
presence of the surgical equipment 16 and/or a cart 19a, etc. with
the surgical equipment 16 thereon. It is contemplated that other
actual attributes of the surgical equipment 16 could be found. The
actual attributes of the surgical equipment 16 can be found using
an image recognition algorithm (e.g., using Haar Cascade
classifier). Such image recognition algorithms are well known to
those skilled in the art. It is also contemplated that the surgical
equipment 16 could include a linear or matrix bar code thereon for
determining the actual attributes of the surgical equipment 16. It
is further contemplated that the surgical instruments 12 could
include indicators thereon for assisting in determining the actual
attributes of the surgical instruments 12, For example, two
surgical instruments 12 may have the same outside configuration,
but have different internal parts on components. In such a
situation, the different surgical instruments 12 could include each
include a different exterior visual indicator (e.g., a modulated
infrared or other spectrum beacon, different colors, or different
linear or matrix bar code thereon) to allow the computer system 48
to properly identify the surgical instrument 12.
[0039] For the example of the surgical equipment 16 on the floor 18
of the operating room 10 illustrated in FIG. 1, the actual
attributes of the surgical equipment 16 could include the style of
the surgical equipment 16. For example, the computer system 48 can
determine the style of the shaver 136 (e.g., arthroscopic shaver or
ENT shaver) and/or the brand (i.e., manufacturer) of the shaver
136. The actual attributes of the surgical equipment 16 could also
include the location of the surgical equipment 16 in the operating
room 10 or in relation to the surgical table 200 configured to
support a patient thereon during surgery, the location of the
surgical table 200 in the room, the height and orientation of the
surgical table 200, or the location of the surgical equipment 16 on
a particular shelf on a particular one of the carts 19a, etc. For
example, the computer system 48 can determine the location
(including orientation) of the surgical equipment 16 on the carts
19a, etc, or the location of the carts 19a. Moreover, actual
attributes of the surgical instruments 12 could further be a
determination of the presence of the surgical equipment 16. For
example, the computer system 48 can determine that the carts
19a-19e are in the operating room 10. The actual attributes can be
a combination of any of the above-noted actual attributes.
[0040] After the computer system 48 obtains actual attributes of
the surgical equipment 16 at step 108, the computer system 48
compares the actual attributes of the surgical equipment 16 with
desired attributes of the surgical equipment 16 at step 110. The
desired attributes of the surgical equipment 16 are stored in a
digital preference storage. The digital preference storage can be
saved in the computer system 48 or retrievable by the computer
system 48 as outlined above.
[0041] In the method 100 of properly locating the surgical
equipment 16, if the actual attributes of the surgical equipment 16
are identical to the desired attributes as determined at decision
step 112, no further action is taken or the computer system 48
issues instruction information indicating that no further action is
needed at step 114. The computer system 48 can issue an indication
that no further action is needed using any visual and/or audio
notification. For example, the computer system 48 can issue an "OK"
message on the display or monitor 49, can flash a green light, can
issue audio stating that all of the surgical equipment 16 are
proper and in the correct location or any combination of the
above.
[0042] However, if the actual attributes of the surgical equipment
16 are not identical to the desired attributes as determined at
decision step 112, the computer system 48 issues instruction
information at step 116. The instruction information will provide
instructions for correcting the actual attributes of the surgical
equipment 16 to be identical to the desired attributes. The
instruction information can include displaying the instruction
information on a display or monitor 49 of the computer system 48
and/or providing audible directions over a speaker (not shown). The
instruction information could also include instructions for
locations of pieces of surgical equipment 16 that is not in the
room 10 but should be in the room 10. The instruction information
can include instructions for removing at least one of the pieces of
surgical equipment 16 (including carts 19a, etc.), adding at least
one piece of surgical equipment 16 (including carts 19a, etc.) to
the room 10 and/or moving locations of at least one of the pieces
of surgical equipment 16 (including carts 19a, etc.).
[0043] For example, the instruction information can include
instructions to add surgical equipment, remove surgical equipment
or rearrange the surgical equipment 16 in the operating room 10.
FIG. 6A illustrates an initial arrangement of an operating room 10
with the image capture cart 19a, the pump cart 19b, the RF and
shaver control cart 19c, the insufflator cart 19d, and the waste
container cart 19e on a first side of the table 200 and with a
space 202 for the surgeon with the image capture cart 19a and the
insufflator cart 19d on a first side of the space 202 and the pump
cart 19b, the RF and shaver control cart 19c and the waste
container cart 19e on a second side of the space 202. FIG. 6A also
includes the portable monitor 135a and the portable overhead light
56a on a second side of the table 200. The instruction information
can include instructions to add an instrument cart 19f having the
table 14 with the surgical instruments 12 thereon adjacent the
space 202 for the surgeon as illustrated in FIG. 6B, remove the
portable overhead light 56a as illustrated in FIG. 6C, swap
positions of the portable overhead light 56a and the portable
monitor 135a as illustrated in FIG. 6D, or move the portable
overhead light 56a to an end of the table 200 as illustrated in
FIG. 6E. The examples of FIGS. 6A-6E are for illustrative purposes
only and are not exhaustive examples of the rearrangements that can
be made according to the instruction information. It is
contemplated that the instruction information can also include
instructions for moving surgical equipment 16 between different
shelves on a single cart 19a, etc. or to change some of the
surgical equipment 16 on a single cart 19a, etc.
[0044] In the illustrated example, after receiving the instruction
information, the hospital personnel can then conform the actual
attributes of the surgical equipment 16 to be identical to the
desired attributes at step 118. It is contemplated that the method
100 of properly locating the surgical equipment 16 can return to
step 104 after step 118 to ensure that the surgical equipment 16 is
properly located.
[0045] It is contemplated that the computer system 48 can be
programmed to observe the layout of the surgical devices in the
operating room 10 and record the actual attributes of the surgical
devices to form the desired attributes of the surgical devices to
be stored in the digital preference storage. It is further
contemplated that the computer system can obtain desired
configurations for the surgical equipment from the digital
preference storage associated with a particular person to be using
the operating room (e.g., surgeon) and/or with a particular
procedure to be performed and configure the surgical equipment
according to the desired configurations. For example, the procedure
for configuring surgical equipment as set forth in U.S. Patent
Application No. 62/100,286 entitled METHOD OF CONFIGURING DEVICES
IN AN OPERATING THEATER, the entire contents of which are hereby
incorporated by reference, can be used.
[0046] Another aspect of the present invention is to obtain images
of numerous people/personnel 400 and objects in a medical facility
and saving and analyzing the images to improve efficiency of the
medical facility. In this aspect of the present invention, sensors
and/or cameras 320 are located throughout the medical facility to
track potentially everything moving within the medical
facility.
[0047] FIG. 7 illustrates a schematic view of a floor 300 of a
medical facility. The illustrated floor 300 includes a plurality of
the medical care areas 10, entrance areas 302 for the medical care
areas 10, and hallways 304. Care area doors 306 allow entrance from
the entrance areas 302 to the medical care areas 10, medical
entrance doors 308 allow entrance from the hallways 304 to the
medical care areas 10, entrance openings 310 allow entrance from
the hallways 304 to the entrance areas 302, and hallway doors 312
are located between different sections of hallways 304. In FIG. 7,
the camera and/or sensors 320 are located in the hallways 304, in
the entrance areas 302 and the medical care areas 10 to allow for
viewing everywhere in the medical facility and particularly at the
care area doors 306, the medical entrance doors 308, the entrance
openings 310 and the hallway doors 312 to view ingress and egress
of people/personnel 400 and devices through those areas. While the
camera and/or sensors 320 are illustrated as only being in the
hallways 304, in the entrance areas 302 and in the medical care
areas 10, it is contemplated that the camera and/or sensors 320
could be located throughout the medical facility. For example, the
camera and/or sensors 320 could be located at entrances to the
medical facility, at elevators doors, at stair doors, at patient
rooms, in storage rooms, in waiting rooms, in operating rooms, at
an emergency department, in a catheterization lab, throughout a
labor and delivery floor, at a pre-operational unit, at a post
anesthesia care unit, at intensive care units, at radiology, at a
hospital pharmacy, at a facilities management area and at a sterile
processing department. The above list is for example purposes only
and is not exhaustive.
[0048] The illustrated camera and/or sensors 320 can potentially
track everything moving through the viewing area of the camera
and/or sensors 320. The camera and/or sensors 320 may be active or
passive and can capture images or sense personnel, movement and
medical devices (and other objects). The camera and/or sensors 320
can have a wide-angle lens and processing software that tracks
personnel, movement, medical devices (and other objects) and
patterns. The camera and/or sensors 320 can also have the
capability to capture depth information using an active scanning
method (e.g., a 3D scanner as is well known in the art). The camera
and/or sensors 320 can capture images in color, black and white, or
in the infrared. Examples of the camera and/or sensors 320 can
include the room camera 36b fixed to walls 52 or the ceiling 54 of
the room 10 as outlined above and the camera 36c in the overhead
light 56. It is contemplated that the camera and/or sensors 320 can
include a combination of motion sensor and camera wherein the
camera is activated when motion is sensed by the motion sensor. It
is further contemplated that the camera and/or sensors 320 can be
composed of sensors that can sense passage of personnel and medical
devices without capturing an optical image thereof (e.g., by
reading RFID chips on the personnel and medical devices).
[0049] In the illustrated example, the captured images and/or
sensed personnel and medical devices (and other items) are
processed to determine the personnel and medical devices (and other
items) passing through an area in front of the camera and/or
sensors 320. It is contemplated that the camera and/or sensors 320
can have an on-board computer system to analyze the personnel and
medical devices (and other items) to determine the characteristics
thereof. For example, the camera and/or sensors 320 can have a
computer system that includes one or more processors or other
similar control devices as well as one or more memory devices. The
processor controls the overall operation of the computer system and
can include hardwired circuitry, programmable circuitry that
executes software, or a combination thereof. The processor may, for
example, execute software stored in the memory device. The
processor may include, for example, one or more general- or
special-purpose programmable microprocessors and/or
microcontrollers, application specific integrated circuits (ASICs),
programmable logic devices (PLDs), programmable gate arrays (PGAs),
or the like. The memory device may include any combination of one
or more random access memories (RAMs), read-only memories (ROMs)
(which may be programmable), flash memory, and/or other similar
storage devices. It is contemplated that the computer system for
the camera and/or sensors 320 can run an image recognition
algorithm (e.g., using Haar Cascade classifier) to analyze the
personnel and medical devices (and other items) to determine the
characteristics thereof. It is further contemplated that the
personnel and medical devices (and other items) could include
indicators thereon (e.g., different exterior visual indicators as
outlined above) for assisting in determining the characteristics
thereof. For determining the identity of the personnel, facial
recognition and/or other features (e.g., height, walking gait,
clothing, etc.) can be employed to properly identify the particular
personnel. The computer system for the camera and/or sensors 320
can then send the aggregate information on the personnel and
medical devices (and other items) to a central computer system 399
(via a wired system or wirelessly). Alternatively, the camera
and/or sensors 320 can send captured images and/or sensed
information to the central computer system 399 (via a wired system
or wirelessly) for recognition and analysis by the central computer
system 399. The central computer system 399 can also include one or
more processors or other similar control devices as well as one or
more memory devices as outlined above.
[0050] The illustrated central computer system 399 uses the
information on the personnel and medical devices (and other items)
along with further information to identify and measure
opportunities for efficiency improvements that exist with a day of
surgery workflow, optimize roam design elements by specifying
equipment placement and personnel movement, and standardize care in
an effort to improve patient outcomes. One example of further
information is usage details of medical devices 16. For example,
the amount of usage of the shaver 136 (e.g., speed and time), type
of images recorded in the image and video capture and recording
device 50, type of light emitted from the scope light source unit
126, type and/or amount of fluid passed using the fluid management
pump 132, usage of the insufflator 141, and usage of an additional
monitor 135, with all of this information being sent to the central
computer system 399 (either directly or through another system
(e.g., from the image and video capture and recording device 50
when the image and video capture and recording device 50 is
connected to the other medical devices 16 in the room 10)). The
above list is for example purposes only and is not exhaustive. The
usage details from the medical devices 16 can be retrieved by the
central computer system 399 or can be sent to the central computer
system 399 at a rate dependent and unique to each medical device
16. Moreover, the method 100 of properly locating the surgical
equipment 16 can include an associated method of properly locating
personnel 400. In the associated method of properly locating
personnel 400, facial recognition software can be used to determine
the personnel 400 in the room 10 and providing instruction
information in the method 100 could also include instructions for
adding essential personnel for a particular procedure that are
currently absent from the room 10. For determining the identity of
the personnel, other features in place of or in addition to facial
recognition (e.g., height, walking gait, clothing, etc.) can be
employed to properly identify the particular personnel.
[0051] FIG. 8 illustrates a method 401 of improving efficiency in
the medical facility. In a first step of the method 401, images of
personnel and/or medical devices (and other items) are captured or
the personnel and/or medical devices (and other items) are sensed
using the cameras and/or sensors 320 at step 402. The images and/or
the sensed information is then processed at step 404 to determine
the characteristics of the personnel and/or medical devices (and
other items) (e.g., identity of the personnel). Further information
is then collected at step 406, with all of the information, images
and other sensed items comprising collected data. The central
computer system 399 is capable of residing on or being connected to
the existing network of the medical facility to obtain the further
information. The further information can be obtained for the
hospital information system ("HIS"), the electronic medical record
("EMR") and/or scheduling system (which keeps track of patients and
the reason and timing for their visit (e.g., location, time and
type of surgery)). The further information will enable the system
to aggregate case-specific information including: staff assigned to
a given case, procedure type, original scheduled time, actual start
time, and other data pertinent to analyzing workflow and
efficiency. It is contemplated that the central computer system 399
can be capable of operating on a standalone isolated system
separate from the hospital IT network, HIS, EMR, and scheduling
system such that the further information would not include
information obtainable from these networked databases.
[0052] Finally, the collected data is analyzed at step 408 to
optimize the performance to thereby improve efficiency in the
medical facility. The analyzed data can be used to identify and
measure opportunities for efficiency improvements that exist.
Software data processing can provide actionable intelligence in
real-time or on-demand to pre-defined user groups. The software
data processing can be done locally on-site on custom processing
hardware or on available server infrastructure, or done remotely in
a cloud configuration. The computer system can provide reports and
alerts to nurses, surgeons, technicians, and administrators. The
collected data can be stored, analyzed, and available per
surgeon/procedure, patient, and institution, and can be used to
assist the surgical staff in standardizing care across surgical
units, institutions, and regions.
[0053] One example of an opportunity for improving efficiency is by
tracking personnel movement and patterns. The tracking information
can include tracking patient, physician, scrub tech,
nurse/non-scrub, personnel not assigned to a current procedure, and
unidentified non-hospital personnel entry into and exit from the
room 10. Facial recognition software can be employed in step 404 of
the method 401 to determine the identity of the personnel. Other
features in place of or in addition to facial recognition (e.g.,
height, walking gait, clothing, etc.) can be employed to properly
identify the particular personnel. Such personnel information can
be analyzed (along with further information) to determine, for
example, the most efficient personnel for a procedure, for tracking
the personnel to improving staffing policies and for determining if
improved security is needed.
[0054] In the illustrated example, the facial recognition and/or
other features as outlined above can be used to determine the
personnel 400 in the room 10 and saved as part of the medical
record. It is contemplated that the cameras 320 including room
camera 36b fixed to walls 52 or the ceiling 54 of the room 10
(e.g., the room camera 36b as shown or a camera 36c in an overhead
light 56), a 360.degree. camera, a wide-angle camera, a camera on
the computer system 48, the video camera 120 and/or any other
camera in the room 10 can be used in the process of identifying the
personnel 400 in the room 10. Once the images of the personnel 400
in the room 10 are obtained, facial recognition and/or other
features as outlined above can be used to determine the identity of
the personnel 400. It is contemplated that the cameras 320 can take
an image of everyone in the room 10 at a particular time (e.g.,
automatically (for example, when the room is scheduled to have
surgery performed therein) or manually (for example, by pressing an
icon on a touchscreen attached to the computer system 48)). It is
also contemplated that the cameras 320 can take images of the
personnel 400 in the room 10 over a series of time frames or
constantly (e.g., every minute during the time the procedure is
scheduled, every time one of the doors 306, 308 is opened or
constant viewing looking for any additional personnel 400 that
enters the room 10). The opening of the doors 306, 308 can be
viewed using cameras and/or determined from barometric changes in
the room. Once the identity of the personnel 400 in the room 10 is
determined, a record of the personnel 400 can be saved
automatically or manually to the record of the patient (e.g., in
the EMR). The identity of the personnel 400 in the room 10 can also
be saved in an operative note of the procedure. For example, the
personnel 400 in the room 10 during a procedure can be saved in a
surgical note created using the process set forth in U.S. patent
application Ser. No. 14/853,289 entitled INTRA-SURGICAL
DOCUMENTATION SYSTEM.
[0055] In the illustrated example, it is contemplated that the
facial recognition and/or other recognition techniques as outlined
above can be used to confirm the identity of the personnel 400
after the identity of the personnel 400 has been entered into the
computer system (e.g., automatically from a scheduling program or
manually) or after the identity of the personnel 400 has been
identified using another automatic system (e.g., by reading an RFID
chip worn by the personnel). Mismatches between the reading using
facial recognition and/or other recognition techniques as outlined
above and the identity of the personnel 400 entered into the
computer system or identified using another automatic system can be
flagged for additional review. If the personnel 400 is not entered
into the computer system or identified using another automatic
system, the identity of the personnel 400 can be confirmed in other
manners (e.g., having the personnel 400 speak their name for
recordation or enter their name into the computer system). It is
further contemplated that the computer system can raise an alarm if
improper or blacklisted personnel 400 are in the room.
[0056] Another example of an opportunity for improving efficiency
is by tracking setup and cleanup of the room 10. For example, the
following can be tracked: number of personnel involved, total time
of setup and/or cleanup, active working time vs. idle time, time
between completion of cleanup and start of next case setup, and
time for setting up the room 10 per procedure type. The cameras
and/or sensors 320 can capture images and/or sense information in
the room 10 (in step 402) and the further information (e.g.,
schedule for the room and timing) (in step 406) can be analyzed in
step 408 to improve the efficiency of cleaning up and setting up
the room 10. For example, the quickest clean ups and set ups can be
analyzed to determine the most efficient method of cleaning up and
setting up the room 10 to be used in future clean ups and set ups.
Moreover, personnel can be rerouted to other areas during their
idle time to improve the efficiency of the personnel. Furthermore,
the time between clean up and start of next setup can be analyzed
to reduce the time the room 10 is not being used to maximize use of
the room 10.
[0057] The analyzed data can also be used for optimizing room
design elements for the room 10 and other areas accessed during the
day of surgery. The impacted design elements include (but are not
limited to): floor plan layout, reflective ceiling plan, equipment
placement, optimal staff positioning, storage requirements, optimal
size of treatment area, and general workflow efficiency
improvements within the hospital. The collected information can
include a height of the patient surgical table 200, position of
surgical scrubbed staff and physician per procedure, movement of
non-scrubbed personnel, entry/exit path of patient, entry/exit path
of intra-operative equipment, recognition of case preferences
(e.g., where equipment, instruments, and other supplies are
placed/positioned per procedure type), movement/positioning of
ceiling mounted equipment, number of times equipment was moved or
reconfigured, equipment usage/durations. The efficiency of the room
can be optimized by analyzing the collected information and
specifying equipment placement and personnel movement in future
procedures.
[0058] The analyzed data can further be used for optimizing
infection control and sterile processing. For example, the number
of infection incidents, location of infection incidents, number of
personnel entries into and exits from the room 10 through the doors
306, 308, duration that the doors 306, 308 are open, number of
sterile field violations (i.e., non-scrubbed personnel within 12
inches of the sterile field or sterile back table), sterile field
transfer protocol violations, sterile processing department staff
time spent on cleaning of the instruments 12, sterile processing
department workflow process, and a percentage of critical areas
cleaned (e.g., by visually determining whether an area was
wiped/cleaned). Such information can be analyzed to reduce
infections or to see where infections occur to determine which
actions can be taken in the future to reduce the possibility of
infection. For example, it is contemplated that the number of times
the doors 306, 308 are opened can be associated with post-operative
infection information to determine if there is a correlation
between the number of times the doors 306, 308 are opened and
post-operative infection. If there is a correlation, the medical
center can establish procedures for an allowable number of door
openings during a particular procedure. Such information (e.g.,
number of door openings) could be saved with the patient record
(e.g., in the EMR). The system could also ascertain a reason for
the doors to be opened and a reason for the ingress/egress of
personnel for improving workflow efficiency and planning. For
example, if a particular type of nurse or doctor has to leave the
room 10 several times or enter/exit after the beginning of a
procedure, such information could be used to assist in better
allocating the schedule and time of that person. Furthermore, the
idle time of particular personnel (or type of personnel (e.g.,
nurse)) could be determined to allow for the particular personnel
(or type of personnel (e.g., nurse)) to be reallocated during the
typical idle times thereof.
[0059] The analyzed data can also be used for optimizing care of a
patient. For example, the following information can be tracked:
active vs. idle time of each staff member during a procedure, drug
administration times and medication error, improvements of the
patient over time, delay in treatment, patient movement/lack of
movement, patient fall warning/traceability, and location of
surgery. If the central computer system 399 determines that
something is improper after analyzing the data, the central
computer system 399 can provide warnings (e.g., warning of
potential wrong-site surgery) to improve care of the patient.
[0060] The analyzed data can further be used for attempting to
determine causes for readmission of a patient. For example, the
following information can be obtained: op/post-op traceability, a
patient readmission to metrics that occurred during their continuum
of care (admission to discharge), infection rate of treatment room
the patient was treated in vs. average infection rate for other
rooms, number of non-essential people in treatment room vs. average
for similar cases, time and/or thoroughness spent on terminal
cleaning of treatment room prior to the medical procedure, number
of times a non-sterile door was opened during the medical procedure
and/or any violations of a sterile field or back table that
occurred during the medical procedure. All of the information can
be analyzed to determine steps that can be taken in the future to
minimize possibilities of readmission of the patient.
[0061] The analyzed data can also be used for tracking and
improving medical procedures. For example, the following can be
observed and recorded: usage and duration of use of the medical
devices, personnel using the medical devices, number of sponges
and/or needles used during the medical procedure (e.g., to ensure
none are lost during the medical procedure), camera position for
being minimally invasive during a particular medical procedure,
registration and confirmation of implant sizes, anatomical
placement of ports (e.g., trocars, scopes and incisions), hand
placement of staff and physicians per procedure type, surgical
techniques, wasted movements, idle personnel time, handling of
instruments (e.g., when and by whom), time and duration of usage of
any cutting or RF instrument, estimates on the volume of blood loss
or fluid use, time of use of any disposable instrument, and time of
activation of any device (e.g., activation of light source).
Moreover, it is contemplated that algorithms can be used to
identify the personnel 400 entering and exiting the room 10 along
with the function of the personnel 400 entering and exiting the
room 10 during a particular procedure. Such collected data can be
used to develop plans for improving medical procedures. Such
information (e.g., observation of number of devices (for example,
sponges or needles) used in a procedure or critical procedural
steps of a procedure) could prompt notification (e.g., by video or
audio alerts) for corrective action that needs to be taken if
important devices or steps are skipped or missed.
[0062] For all of the image recognition techniques outlined above
(e.g., facial and/or other features as outlined above and device
recognition), it is contemplated that a database of information
needed to recognize the item or person in the image could be stored
locally (e.g., in a memory of the computer system 48, 399) or
externally. For example, the database of information can be stored
externally and obtainable through the Internet or other type of
wide area network (WAN), a local area network (LAN), a corporate
intranet, any other type of network, a combination of such
networks, or can be stored in cloud storage retrievable through a
network interface of the computer system 48, 399. Information can
be saved in the database of information by saving images into the
database of information through any means (e.g., a web application
or a mobile application) and associating names (e.g., name of
person) or other information (e.g., type of device) with each
particular image.
[0063] The analysis of video and/or images of the room 10 can be
used for recognizing specific conditions of the room 10 and
triggering or taking further action within the room depending on
the specific conditions. For example, it is contemplated that the
cameras 320 could review the rooms 10, and if it determined that no
personnel 400 are in the room 10 (and possibly the additional
determination that the time of day is outside normal utilization
hours for the room 10) the computer system could trigger an
ultraviolet room sterilization system 700 to eliminate pathogens in
the room 10. If is further contemplated that the computer system
48, 399 could automatically turn off the ultraviolet room
sterilization system 700 if the cameras 320 determine the presence
of personnel 400 in the room 10 (e.g., personnel 400 entering the
room) unless the computer system 48, 399 is programmed to determine
if the personnel 400 is wearing protection gear (e.g., a special
suit having a recognizable code or a particular type of
reflectivity that can be visually determined) that protects the
personnel 400 for ultraviolet light. It is contemplated that the
system could take other action upon determination that personnel
400 are in or not in the room 10. For example, devices could be
automatically turned on or off depending on whether there are
personnel 400 in the room 10 or not in the room 10.
[0064] In the illustrated example, one or more of the cameras 320
(e.g., the room cameras) could capture video or images outside of
the visible spectrum and the computer system 48, 399 could take
action depending on the analysis of the video or images outside of
the visible spectrum. For example, the cameras 320 could be
infrared cameras that turn off equipment or provide notification
that equipment is too hot for its intended purpose. Therefore, the
equipment could be replaced before the equipment malfunctions. The
cameras 320 could also be a hyperspectral imaging camera or a
multispectral imaging camera. The hyperspectral imaging camera or
the multispectral imaging camera could also sense light waves
outside of the visible spectrum. The hyperspectral imaging camera
or the multispectral imaging camera could provide video or images
to the computer system 48, 399 to allow the computer system 48, 399
to notify the personnel 400 of certain conditions or take automatic
action under certain conditions. For example, the computer system
48, 399 could alert the personnel 400 if the hyperspectral imaging
camera or the multispectral imaging camera detect waste anesthesia
gases venting into the room 10 instead of into a waste anesthesia
gas disposal system. In another example, the computer system 48,
399 could alert the personnel 400 if the hyperspectral imaging
camera or the multispectral imaging camera detect an increased
volume of contaminants (e.g., dust or other particular matter)
venting into the room 10 through the HVAC system.
[0065] The illustrated room 10 can also include one or more
microphones 800 to receive audio in the room 10 for analysis by the
computer system 48, 399. The microphone 800 can be fixed within the
room 10 or can be portable and be wired or wireless connected to
the computer system 48, 399. For example, it is contemplated that
the microphone 800 could be worn by the personnel 400 (e.g.,
surgeon) or could be located in any of the devices. The computer
system 48, 399 could analyze the audio received by the microphone
800. For example, the computer system 48, 399 could monitor the
sounds from the medical equipment 16 for alarms or other telltale
sounds that the equipment is not working properly (e.g., a
high-pitched whine indicating a clogged air intake filter) and
alert the personnel 400 in the room 10 or outside of the room 10 if
an alarm count exceeds a preset number for the procedure in the
room 10. The alert could be audio within the room, audio to
personnel 400 outside the room, turning down music within the room,
dimming or flashing lights in the room, placing text or other
indicators on monitors or any other method of alerting personnel of
issues. The computer system 48, 399 could monitor instructions from
one of the personnel 400 in the room 10 (e.g., a doctor) and
provide an audio or visual alert (e.g., on a monitor) if a
discrepancy is detected between the instruction and the response by
reviewing the audio response or by analyzing the video or images
from the cameras 320 for the non-verbal action taken from the
instructions. The computer system 48, 399 could monitor
communications of the personnel 400 in the room 10 (e.g., a doctor)
and automatically reduce the volume level of music playing in the
room 10 under certain conditions (e.g., during prolonged verbal
communications between the personnel 400 or when elevated levels of
stress in the voices of the personnel 400 is detected). In addition
to or as an alternative to reducing the volume level of music
playing in the room 10 under the certain conditions, additional
personnel 400 could be automatically called to the room 10. The
audio recorded by the microphones 800 can be saved on the computer
system 48, 399 or in the patient's record for later analysis (e.g.,
analysis to the audio to make correlations between interruption
frequency (from, for example, equipment alarms, phone calls, etc.)
and post-operative recovery issues so that potential conclusions
can be drawn for improvement in patient safety.
[0066] In the illustrated embodiments as outlined above,
instructions are given to personnel for many reasons. For example,
instructions can be given to personnel in order to match actual
attributes of the surgical devices with desired attributes of the
surgical devices. It is contemplated that augmented reality system
can be used to provide the instructions to the personnel in order
to allow them to match the actual attributes with the desired
attributes. An example of an augmented reality system that could be
used is the Microsoft HoloLens as sold by Microsoft Corporation of
Redmond, Wash. The augmented reality system can be worn by the
personnel to show exactly where the surgical devices should be
positioned.
[0067] Although particular preferred embodiments of the invention
have been disclosed in detail for illustrative purposes, it will be
recognized that variations or modifications of the disclosed
apparatus, including the rearrangement of parts, lie within the
scope of the present invention.
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